This inspection took place over two days. We arrived on the 10 December and returned on the 11 December to complete our inspection.
At the last inspection on 29 October 2013 we found that the service was compliant with the regulations we looked at.
Harmony Care and Support provides care and support to people living in their own homes. The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service told us that on the whole they felt safe with the support workers who supported them.
Staff had received training on how to keep people safe from harm and support workers knew what to look out for and the procedure to follow, if they felt that someone was at risk.
We found that not all the risks associated with people’s care and support had been properly identified or assessed. Comprehensive plans of care were in place though not all were up to date or accurate.
We found some concerns regarding the management of medicines. Records had not always been completed to demonstrate that people had been supported to take their medicines. Support workers had not always had the required information to enable them to assist people with the application of their creams as prescribed by their doctor.
Checks had been carried out when new staff had been employed to check that they were suitable to work at the service and training was then provided to enable the staff to meet the needs of those in their care.
Support workers had been provided with an induction into the service and ongoing support in the form of supervisions, spot checks and team meetings had taken place.
For people who needed assistance at meal times, support workers provided this and this was recorded in their daily notes. This enabled the support workers to determine whether people were getting sufficient to eat and drink and act appropriately, if they were not.
People who used the service and/or relatives had been involved in deciding what care and support they needed and had been involved in the development of their plan of care.
People told us that the support workers were kind and caring and we observed this when we visited two people who used the service. Support workers provided people with choices when they were assisting them and provided their care and support in a way they preferred.
People who used the service and their relatives were supported to make complaints about the service they received, though not everyone spoken with felt that their concerns were taken seriously. When complaints had been received, these had not always been dealt with in line with the provider’s complaints procedure.
People who used the service shared their concerns with regard to the number of different support workers who visited them. They told us that they would much prefer regular support workers visiting. The registered manager acknowledged this.
Systems were in place to monitor the service being provided, though these were not always effective in identifying shortfalls within records held.
The people who used the service were asked their opinion of the service on a regular basis and the support workers felt supported by the management team.